Biomedical subjects
Publications and source records attributed to C Ladefoged.
A fibroadenoma in the female breast is described, which contained multiple multinucleated giant cells within the stroma. The investigation indicated the giant cells to be of epithelial nature, caused by epithelial degeneration secondary to myoepithelial swelling of unknown cause. Their presence and morphology could cause anxiety about malignancy, but this was found groundless.
Material from intervertebral discs obtained from 30 randomly selected autopsies was examined histologically for amyloid deposits. Various degrees of amyloid degeneration were found in the disc tissue from 28 of the autopsies. In the annulus fibrosus, the amyloid was lying between the thick bundles of collagen fibers, compared to a more diffuse nodular distribution in the nucleus pulposus, frequently in close relation to chondrocytes. With regard to the lumbar discs, a significant correlation was found between the occurrence of islands of chondroid tissue in the annulus fibrosus and amyloid degeneration. Significantly more amyloid was observed in disc tissue in older age groups, while the amount of amyloid was similar in discs from men and women. Calcium-pyrophosphate-dihydrate (pyrophosphate) was found in the tissue of 6 of the 7 women over the age of 70. Calcium phosphate was seen in 22 of the autopsies--more frequently in the annulus fibrosus than in the nucleus pulposus. There was no topographical relationship between calcium phosphate and amyloid.
Explore the source record for details and available documents.
The material from 100 consecutive aortic and mitral valve operations has been studied histologically with particular reference to the presence of amyloid deposits. Sixty seven per cent were positive (aortic 88%, mitral 45%). The simultaneous occurrence of calcification of the valves and amyloid degeneration as well as of calcification and hyalinization was significant. Similarly there was significantly more amyloid in the older age groups, as well as a significant correlation between the degree of hyalinization of the valve and amyloid. Thirty-two patients had previously suffered from rheumatic fever. The heart valves of these patients did not differ histologically from the others, whereas significantly more amyloid was observed in the stenotic mitral valves than in the mitral valves which were insufficient.
In a 47-year-old man left nephrectomy was performed in 1982 because of a solitary metastasis arising from a bronchial adenoid cystic carcinoma which had been extirpated 23 years previously, in 1959. Whole-body CT scanning one year after nephrectomy disclosed no local recurrence or further metastasis. The importance of long follow-up after surgery for adenoid cystic carcinoma is emphasized.
Explore the source record for details and available documents.
The relationship between osteoarthritic change and amyloid degeneration was studied in 116 joint capsules from osteoarthritic hip joints. Twenty-seven (23%) contained amyloid deposits. Twenty-eight joint capsules showed chondroid metaplasia in the fibrous part. Significantly more amyloid degeneration was found among these. Six joint capsules contained pyrophosphate crystals. Five of these were positive for amyloid. Chronic inflammation of the joint capsule was found in 80% of the cases and was negatively correlated with amyloid degeneration, which is in good agreement with the biphasic theory for the pathogenesis of amyloid. Further investigation is necessary to decide how chondroid metaplasia takes part in the production of amyloid.
A total of 116 osteoarthritic femoral heads were studied with regard to the relationship between amyloid deposits in the cartilage and osteoarthritic changes. All the femoral heads were found to be deformed and only 10 were covered by cartilage over the whole surface. Sixty-five per cent of the femoral heads showed amyloid degeneration of the cartilage surface. The amount of amyloid did not correlate with the extent of the erosion. Neither was there a significant correlation between the amyloid degeneration on the one hand and fibrillation and flaking of the cartilage surface on the other. A reduction in the amount of chondroitin sulphate was observed in all 116 femoral heads to varying degrees, but no correlation with amyloid could be demonstrated. Thus, in the present study no correlation between the morphological and histochemical degrees of osteoarthritis and amyloid has been found. Six out of seven femoral heads with pyrophosphate deposits in the cartilage also contained amyloid.
Amyloid depositions in tissue from 116 osteoarthritic hip joints were examined. There was no significant correlation between amyloid and age although there was a tendency for joints from older patients to have more marked amyloid degeneration. We found significantly more amyloid in the joint capsules from male patients than from females. No difference in amyloid deposition was found between the right and left side, and pressure-loaded/less pressure-loaded parts of the femoral head contained equal amounts of amyloid. With the exception of two cases amyloid depositions in the joint capsule were always accompanied by amyloid in the joint cartilage (P less than 0.001). Conversely the cartilage was often positive when the capsule was negative for amyloid.
The occurrence of amyloid in capsular tissue and cartilage from human hip joints were studied by the macroscopic iodine/sulphuric acid test, by light and polarization microscopy, and finally by electron microscopy. It is concluded that the congophilic substance with green dichroism, which in an earlier light and polarization microscopic study was found in a large percentage of hip joints of elderly persons, is amyloid.
Thirty-nine severely calcified aortic valves surgically removed were studied for amyloid deposits using the alkaline Congo red stain. Amyloid deposits were found in all the valves, in such quantities that they could be demonstrated using screening magnification (x40). A close topographic relationship was found between amyloid and calcium deposits. In addition, histological evidence was found of prolonged fibroblast proliferation. In the light of more recent studies, which identify Congophilic cytofilaments in fibroblasts, as well as demonstrating fibroblast degeneration and decomposition in senile aortic valves, the following pathogenesis is suggested for "calcific aortic stenosis": Mechanical injury of malformed aortic valves leading to fibroblast proliferation; fibroblast degeneration and decomposition with extracellular accumulation of cellular degradation products (among others Congophilic cytofilaments); calcium deposits in the cellular degradation products resulting in "calcific aortic stenosis".
Pyrophosphate and capsular chondromatosis were demonstrated histologically in 15 cases, 14 of which also exhibited local deposition of amyloid. A systematic examination of the joint capsule in 57 consecutive hip replacement operations for osteoarthritis revealed these changes in 6 of the cases (10.5 per cent). Microscopic examination which was done if intraarticular calcifications were grossly visible at operation, showed the same changes in 8 knees, 4 with osteoarthritis and 4 with meniscal disease. The changes were also seen in the menisci. Only one patient was suffering from chronic, polyarticular pyrophosphate arthritis. In the other cases neither change had been expected a priori, and the patients had no signs of systemic articular disease or amyloidosis. Most of them were elderly, but in good health.
Cartilage and fibrous capsular tissue from the hip joints of 30 unselected autopsies have been examined for the presence of congophilic substance with green dichroism (CS-GD). Ninety-three per cent of the cases had CS-GD in the joint cartilage and 43 per cent contained amyloid deposits in the capsule. The relation of these substances to age and the relation of CS-GD to the upper and lower parts of the femoral head cartilage have been studied, as well as the inter-relationship between the presence of CS-GD in the cartilage and amyloid deposits in the capsule within each joint.
Placental tissue from 160 abortions provoked during the 6th--12th weeks, and 109 spontaneous abortions between weeks 5 and 16, were studied histopathologically on respect of a comparison and quantitation of hydrop degeneration. Significantly more cases of severe hydrop degeneration were observed among the spontaneous abortions (p < 0.001). Of these abortions, 87 per cent were hydrop degenerated to varying degrees; 41 per cent were severely hydrop degenerated. Among the provoked abortions, approximately 81 per cent were hydrop degenerated to varying degrees but only 6.9 per cent were severely hydrop degenerated. The relationship between severe hydrop degeneration and chromosome abnormality is discussed.
The material comprises 225 patients. In 79 patients 35.1%) the tumour was closely excised and in a few cases biopsied before the patients underwent radical surgery. 146 patients were radically operated primarily. These two groups of patients are comparable with regard to sex, distribution of tumours on anatomical sites and the distribution of tumours with a given histological classification. We have ascertained that neither excision biopsy nor non-radical operation influences the prognosis if followed by radical operation within about 3 weeks.
By using cumulative survival curves the influences of histological criteria of the primary tumour on the prognosis of 204 patients with clinical stage I malignant melanoma were evaluated. Tumour thickness, level of invasion in the dermis plus ulceration appear to have greatest influence on prognosis. Other factors influencing prognosis include that histogenetic type of melanoma, malignant cell invasion into blood vessels as well as intralesional transformation. On the other hand, it appears from our material that the number of mitoses, the type of malignant cell, regression phenomena and the amount of the inflammatory cell infiltrate have no significant influence on prognosis.